This article describes the contribution of psychiatrie nursing to an comprehensive approach to the treatment and management of severely ill psychiatrie in-patients. The patients posed agressive, suicidal and acting-out problems to an extent that made them hardly amenable to treatment. The author stresses the role of the nursing staff in creating a structured human environment in which nursing staff can temporarily take over those psychological functions, which the patient is unable to exert by himself in that particular period of illness. As the patient gradually regains his or her self-controlling capabilities the exercition of psychic functions is rendered to the patient by allowing more latitude to organize and shape his or her behavior. This approach requires skillfull observation and monitoring of interactions between patients, delicate handling of patient-staff interactions and intensive and meticulously organized cooperátion between all staff members of the various professions involved. Classic and more up to date therapies are integrated in the overall approach by a multidisciplinary treatment team.